This article reviews the basic principles and evidence for the effectiveness of a semantic-based treatment for naming deficits in aphasia. This article focuses on three aspects of semantic-based treatment. First, the theoretical basis for semantic treatment approaches to alleviate naming deficits is explained. Second, the different types of semantic treatment approaches (i.e., substitutive and restitutive treatments) are reviewed. More attention is provided to restitutive treatment approaches, and some ideas regarding why these treatments may be effective are discussed. We argue that strengthening access to impaired semantic and phonologic representations and facilitating generalization to untrained but related targets are two factors determining the success of a restitutive-based semantic treatment. Finally, in the third section of the article, the effect of semantic treatment on the overall communicative effectiveness and suggestions for future research in this field are discussed.